Changing paradigms in retinopathy of prematurity (ROP) in the Neonatal Intensive Care Unit of Hospital de Clínicas de Porto Alegre

Abstract

Objectives: This study aims to evaluate the incidence for ROP treatment among extremely low birth weight (ELBW) premature babies comparing two different periods in which an increase in the survival rates among ELBW occurred. Methods: A prospective cohort study was conducted from 2002 to 2024. Patients were included in 2 groups: Group 1 included neonates treated for severe ROP during the years 2002-2015 and group 2 included babies treated during the years 2016-2024. Variables were: birth weight (BW), gestational age (GA), post-conceptional age (PCA) at treatment. Outcomes were incidences of severe ROP in both groups, and regression of ROP after treatment during the entire observational period. Statistical comparisons between variables in both groups were performed. The significance level used was P<0.5. Results: The incidence of 12.8% of severe ROP needing treatment was reported during the entire period of the study. Group 1 included 23 patients and the incidence of ROP was 12.04%. Group 2 included 18 patients and the incidence of ROP was 14.06%, (P = 0.198). Mean BW and mean GA in group 1 were 808.0 ± 110.4g and 27.4 ± 1.9 weeks while in group 2 were 656.9 ± 111.6g and 25.1 ± 0,9 weeks, respectively. Post-conceptional age at treatment was 37.5 ± 1.4 weeks in group 1 and 36.2 ± 1.5 weeks in group 2 (P<0,03). According to the statistical analysis, both groups were different regarding the considered variables BW, GA, and PCA (P<0.0001, P<0.0001, and P<0.03), respectively. Conclusions: The higher survival rate, higher incidence of ROP and greater need of treatment in ELBW preterm babies indicate that these ELBW patients should receive special attention by ophthalmologists during the screening for ROP.